Logan Health - Whitefish receives PIN Quality Improvement Award for Improving Care Transitions
Logan Health – Whitefish was presented the Montana Rural Healthcare Performance Improvement Network’s Quality Improvement Award for improving care transitions at the Critical Access Hospital regional meeting held in Whitefish on Tuesday, November 14. Accepting the award were Nancy Henriksson, Sr. Director Quality, Risk and Performance Improvement, Marissa Hepner, Director Care Continuum, Rachel Naples, Quality Improvement Specialist, and Amy Vanterpool, Chief Clinical Officer.
The award was given for a project initiated in 2022 by Logan Health – Whitefish (LHW) that focused on a challenge with patients being discharged yet were actively declining and often returned to the hospital. The project identified barriers contributing to the patient's decline and community needs in rural areas such as food insecurity, access to mental health, transportation, provider access and availability, and post-discharge placement opportunities.
The project implemented the practice of screening all patients for social determinates that may contribute to their decline in health. If needs were found their care team provided the appropriate education and resources. Additionally, all patients discharged would receive a follow up call that includes transitional care management care coordination for their specific identified needs.
As a result of the project, readmission rates have steadily decreased.
The biggest learned experience is that for a patient to be successful after discharge the team approach is the best medicine. Teamwork by the care team, along with communication with the patient can lead to decreased readmission, better home care, and a better understanding of all aspects of their treatment. LHW’s Planetree Culture has contributed to the success of this project as it drives how patient care is delivered by involving the patient in their care and understanding their perspective.